Clinical psychologist Ann Tatu says a mother’s recovery after childbirth cannot be neatly separated into physical and mental health.
“Mental health really can’t be separated from physical wellness,” she explains. “A mother’s mental state can influence how she recovers physically, her milk production and even how she cares for her baby.”
When a mother feels persistently low, anxious or overwhelmed, the effects may extend beyond her own wellbeing to shape a baby’s earliest experiences.
She notes newborns are entirely dependent on caregivers. “They cry, stretch and startle, relying on someone to interpret every signal.”
How quickly and consistently a caregiver responds helps the baby develop a basic sense of trust. Simple acts such as feeding when the baby is hungry or soothing them when distressed play a crucial role in this process.
During the early weeks when a mother is emotionally present and responsive, the baby begins to feel safe. “That sense of safety does not end in infancy; it determines how the child connects with other people later in life. If a mother is struggling and her responses are inconsistent or delayed, bonding may be affected.
“This is not about blaming mothers, but about recognising how closely intertwined maternal wellbeing and infant development are.”
Nairobi-based clinical psychologist Ann Tatu.
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Tatu notes it is common for new mothers to feel tearful or overwhelmed in the first days after delivery. This condition, often referred to as maternity blues, appears within the first two weeks after birth.
“The symptoms are mild and short-lived. A mother may feel worried, unhappy or unusually exhausted. She may cry suddenly, struggle with sleep or feel momentarily confused,” she says.
These changes, Tatu explains, are linked to the normal physiological shifts that happen after delivery. “They do not cause functional impairment and typically fade within two weeks without treatment. Baby blues are not a mental illness.”
Postpartum depression, however, is a different and more serious condition. It falls under major depressive disorders with a peripartum onset, meaning symptoms can begin during pregnancy or after delivery.
“A mother may find it hard to sleep even when the baby is asleep. She might wake very early or sleep far more than usual,” she says.
Appetite may change noticeably, leading to unplanned weight loss or gain. There may be headaches, cramps, or digestive problems that do not respond to treatment and have no clear physical cause.
In severe cases, postpartum depression may present with psychotic features.
“A mother may experience command hallucinations telling her to harm the baby or develop delusions such as believing the baby is possessed,” she says. “These are warning signs that require urgent intervention.”
For spouses and family members, the difference between baby blues and postpartum depression often lies in the duration and severity of symptoms. Tatu warns that if symptoms are intense, last beyond two weeks, interfere with daily functioning or include disturbing thoughts, professional help should be sought.
“Untreated maternal depression does not affect only the mother. During pregnancy, it has been linked to more complications, including babies being more active in the womb, growing more slowly, or being born too early or at a low birth weight,” she says.
Infants of mothers with untreated depression often show higher stress hormone levels and changes in brain and nervous system activity. This may appear as difficulties with sleep, feeding or being soothed.
Can a baby truly sense a mother’s emotional state? “Yes,” she says. “Even before birth, babies can react to their mother’s emotional state. By one month old, infants can pick up on facial expressions, tone of voice and touch. They can sense when a parent is depressed or angry.”
Several forms of psychotherapy, such as cognitive behavioural therapy, can help by teaching the women new ways of thinking and behaving.
A mother should not have to give up her life to create one
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How long does treatment usually take? “This depends, as people are unique and there are different contributing factors for different mothers. It also depends on the form of treatment, whether individual therapy, group therapy, or medication.
Tatu emphasises that women should not stop medication abruptly once they discover they are pregnant.
“Suddenly discontinuing antidepressants can lead to relapse of severe depression and withdrawal symptoms. Any decision to continue, adjust or stop medication should be made jointly with the doctor, balancing the risks of medication against the risks of untreated illness,” she warns.
Support at home can make a difference, too. Practical help, such as taking over some baby duties, ensuring the mother rests, and attending therapy sessions together can ease the burden.
“Encouraging and affirming the mother that she is doing her best can counter the harsh self-criticism that often accompanies depression.”
Tatu believes mental health screening should be a routine part of care, not only after birth but also during pregnancy. “Antenatal and postnatal visits often focus on blood pressure, weight and physical healing. Adding structured mental health screening ensures that emotional struggles are identified early rather than dismissed as weakness or normal adjustment,” she adds.
